Evaluation of Cytokines Contained in the Nasal Secretion of Nasal Allergy Patients

Abstract

We conducted a nasal provocation test, using house dust as the antigen, on 13 patients with perennial nasal allergy and 6 normal subjects. The test was followed by nasal lavage using 25 ml of physiological saline. Using the nasal lavage fluid immediately before the provocation test as the control fluid, the levels of cytokines (IL-1α, IL-1β TNFα) and chemical mediators (LTB4, LTC4, histamine) were determined in the nasal lavage fluid obtained 30,60,120,240,360, and 480 minutes after provocation, and the sequential change in secretory volume per unit of time was investigated. Simultaneously, sequential changes in nasal resistance were determined by rhinomanometry. In the immediate phase reaction,30 minutes after provocation, significant differences (p < 0.05) were noted in the IL-1α, LTC4 levels in the group with nasal allergy and the normal group. In the late phase reaction,360 minutes or more after provocation, no significant difference was noted in the cytokines or chemical mediators between the two groups. A significant difference (p < 0.05) was noted between the levels of IL-1α, TNFα, LTB4, and LTC4 before provocation and those of the immediate phase reaction. However, in the cytokines and chemical mediators, no significant differences were noted in comparing the pre-provocation levels with those of the late phase reaction. Thirty,120, and 360 minutes after provocation, a significant difference (p < 0.05) was noted in the nasal resistance of the group with nasal allergy compared to the normal group. A significant difference (p < 0.05) was noted between the pre-provocation value and the value during the immediate or late phase reaction. Dual phase changes of the immediate and late phase reactions were noted in 9 of the 13 cases. All 6 cases rated as severe or intermediate with regard to daily nasal symptoms exhibited the dual phase reaction. Many of the cases exhibiting a dual phase reaction in nasal resistance showed a repeated rise in the cytokines and chemical mediators during the late phase reaction.